- History of congenital adrenal hyperplasia or 17-hydroxyprogesterone > 300 ng/dL, which
suggests the possibility of congenital adrenal hyperplasia (if postmenarcheal, the
17-hydroxyprogesterone will be collected during the follicular phase, or ≥ 40 days
since last menses if oligomenorrheic). NOTE: If a 17-hydroxyprogesterone >300 mg/dL is
confirmed on repeat testing, an ACTH-stimulated 17-hydroxyprogesterone <1000 ng/dL
will be required for study participation.

- Total testosterone > 150 ng/dL, which suggests the possibility of a virilizing
neoplasm

- DHEAS greater than the upper limit of age-appropriate normal range (mild elevations
may be seen in polycystic ovary syndrome (PCOS) and adolescent hyperandrogenemia (HA),
and elevations < 1.5 times the age-appropriate upper limit of normal will be accepted
in these groups)

- Abnormal prolactin. Mild elevations may be seen in overweight girls, and elevations
<1.5 times the upper limit of normal will be accepted in this group.

- Persistent hematocrit <36% and hemoglobin <12 g/dL. Subjects with a mildly low
hematocrit (33-36%) will be asked to take iron in the form of ferrous gluconate for up
to 60 days. Subjects weighing ≤ 36 kg will take one 300-325 mg tablet oral ferrous
gluconate daily (containing 36 mg elemental iron);subjects weighing >36 kg will take
two 300-325 mg tablets oral ferrous gluconate daily (containing 36 mg elemental iron
each). They will return to the Clinical Research Unit (CRU) after 30-60 days of iron
therapy to have their hemoglobin or hematocrit rechecked and will proceed with the
remainder of the study if it is ≥12 g/dL or ≥36%, respectively.

- Persistent liver test abnormalities, with the exception that mild bilirubin elevations
will be accepted in the setting of known Gilbert's syndrome. Mild elevations may be
seen in overweight girls, so elevations <1.5 times the upper limit of normal will be
accepted in this group.

- No medications known to affect the reproductive system or glucose metabolism can be
taken in the 3 months prior to the study. Such medications include oral contraceptive
pills, progestins, metformin, glucocorticoids, and psychotropics.